Headache and hemiplegic migraine

There's a lot of confusion when it comes to headache and hemiplegic migraine. What exactly is this rare type of migraine, and how do you know you're not dealing with something worse?

Migraine, of course, is much more than just a bad headache. In fact, many migraineurs don't get headache at all (read here for more on migraine symptoms). Migraine symptoms tend to be different for everybody.

What is hemiplegic migraine?

Headache and hemiplegic migraine sometimes go together, and sometimes don't. Hemiplegia is simply paralysis on one side of the body. Someone with hemiplegic migraine has, as one of their symptoms or perhaps their only symptom, trouble moving one side of their body. Since this is a common stroke symptom, it can be frightening. The symptoms usually occur during the migraine attack and sometimes for a while afterwards.

The good news is that the symptoms are only temporary, and are usually gone within 24 hours. (Usually, but not always. Some symptoms may last weeks, but this is less common. If you get a headache, the other symptoms may outlast the headache itself, which is usually short lived.)

Sometimes it affects most of the one side of the body, at other times only a part. Other symptoms may go along with it, such as difficulty speaking. There may be numbness, or a prickly feeling. Hemiplegic migraine can start in childhood or adulthood. The same person may get headaches or migraine attacks without the weakness as well.

Different types of hemiplegic migraine

Headache and hemiplegic migraine can be broken into a couple of catagories:

*Familial Hemiplegic MigraineIn this case there is a close relative (ie sibling, parent, child) that carries the same genes that cause the symptoms. It's important to give your doctor a full family history in order to diagnose familial hemiplegic migraine.*Sporadic Hemiplegic MigraineThe symptoms are the same, but the genetic connection, if any, is unknown. (More on sporadic hemiplegic migraine here.)

Treatment of headache and hemiplegic migraine

There are two main challenges when it comes to treating hemiplegic migraine. First, the paralysis or weakness is simply one more symptom, probably among many others, that need to be treated.

Second, because of the connection between migraine and stroke, and especially the similarities with headache and hemiplegic migraine and stroke symptoms, there is concern about certain medications that may make heart problems worse. This means that some of the most popular medications, the triptans and ergotamines, are usually not recommended for those with hemiplegic migraine. (This is being questioned by some researchers and specialists - you need to talk to your doctor about your own medical history and situation)

Generally, the other common painkillers such as NSAIDs, have been tried successfully. Your doctor may also recommend preventative meds, such as calcium channel blockers, antidepressants, or beta blockers.

The other good news is that new genetic research is allowing us to diagnose even sporadic hemiplegic migraine more accurately. The genes associated with two types of familial hemiplegic migraine are CACNA1A, ATP1A2, and SCN1A. Gene mutations can cause problems in the body, such as calcium or sodium channel malfunctions, sending wrong signals.